The effect of cognitive behavior therapy on body image and self-esteem in female adolescents: a systematic review and meta-analysis
-
Nasrin Zamiri-Miandoab
Abstract
Low self-esteem and negative body image expose girls to many risks and damages. Cognitive-behavior counseling is one of the ways of improving body image and self-esteem. The aim of this systematic review was to determine the effects of cognitive-behavior therapy on body image and self-esteem of adolescent girls. The English (Cochrane library, Web of sciences, EBSCO, PubMed, Google Scholar) and Persian (SID, MagIran) databases were searched without any time limit. The quality of included studies in terms of risk of bias was assessed using Cochran handbook and the quality of evidence was evaluated through Grading of Recommendations Assessment, Development and Evaluation (GRADE). Meta-analysis was performed using RevMan software. Heterogeneity of studies was analyzed by index I 2. Subgroup analysis was performed on the basis of outcome evaluation intervals (after intervention, one month and two months later). A total of 2,664 articles were accessed in different databases of which 2,655 articles were excluded and finally nine studies were systematically reviewed. Meta-analysis results on seven studies (228 participants) showed that the group receiving cognitive-behavior counseling was significantly better than the control group regarding body image (Standardized Mean Difference [SMD]: 13.01; 95% CI: 10.68 to 15.34; I²=26.1%). Likewise, meta-analysis results on two studies (50 participants) showed that self-esteem was not significantly different between the group receiving cognitive-behavior counseling and the control group (SMD: 1.13; 95% CI: −0.7 to 2.32, I²=73%). Meta-analysis results of this study represent effectiveness of cognitive-behavior therapy on body image of adolescent girls; however, since the number of studies in the field of self-esteem is low, more trials in this field with stronger designs are suggested.
-
Research funding: No funding.
-
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
-
Competing interests: Authors state no conflict of interest.
-
Informed consent: Not applicable.
-
Ethical approval: Not applicable.
References
1. World Health Organization. Adolescence – WHO; 2021. Available from: https://www.who.int/maternal_child_adolescent/documents/pdfs/9241591269_op_handout.pdf [Accessed Sep 2020].Suche in Google Scholar
2. World Health Organization. Adolescent health in the South-East Asia region: WHO [cited 2021]; 2021. Available from: https://www.who.int/southeastasia/health-topics/adolescent-health [Accessed Sep 2020].Suche in Google Scholar
3. Goodburn, EA, Ross, DA, Organization, WH. A Picture of health?: a review and annotated bibliography of the health of young people in developing countries; 1995. Avaiable from: https://apps.who.int/iris/handle/10665/62500.Suche in Google Scholar
4. Mohammad-Alizadeh-Charandabi, S, Mirghafourvand, M, Tavananezhad, N, Karkhaneh, M. Prevalence of cigarette and water pipe smoking and their predictors among Iranian adolescents. Int J Adolesc Med Health 2015;27:291–8. https://doi.org/10.1515/ijamh-2014-0028.Suche in Google Scholar PubMed
5. Andrew, R, Tiggemann, M, Clark, L. Predictors and health-related outcomes of positive body image in adolescent girls: a prospective study. Dev Psychol 2016;52:463. https://doi.org/10.1037/dev0000095.Suche in Google Scholar PubMed
6. Furnham, A, Badmin, N, Sneade, I. Body image dissatisfaction: gender differences in eating attitudes, self-esteem, and reasons for exercise. J Psychol 2002;136:581–96. https://doi.org/10.1080/00223980209604820.Suche in Google Scholar PubMed
7. Fuller-Tyszkiewicz, M, Skouteris, H, Watson, B, Hill, B. Body image during pregnancy: an evaluation of the suitability of the body attitudes questionnaire. BMC Pregnancy Childbirth 2012;12:1–11. https://doi.org/10.1186/1471-2393-12-91.Suche in Google Scholar PubMed PubMed Central
8. Body image: national eating disorder collaboration; 2021 [cited 2021]. Available from: https://www.nationaleatingdisorders.org/body-image-0 [Accessed Sep 2020].Suche in Google Scholar
9. Keyvanara, M, Haghighatian, M, Kavezadeh, A. Social factors influencing women’s body image (case study: Isfahan city). J Appl Sociol 2013;23:11–4.Suche in Google Scholar
10. Tiggemann, M. Body dissatisfaction and adolescent self-esteem: prospective findings. Body Image 2005;2:129–35. https://doi.org/10.1016/j.bodyim.2005.03.006.Suche in Google Scholar PubMed
11. Grogan, S. Body image: understanding body dissatisfaction in men, women and children. New York: Taylor & Francis; 2016.10.4324/9781315681528Suche in Google Scholar
12. Shoraka, H, Amirkafi, A, Garrusi, B. Review of body image and some of contributing factors in Iranian population. Int J Prev Med 2019;10:19.10.4103/ijpvm.IJPVM_293_18Suche in Google Scholar PubMed PubMed Central
13. Yari, M, Shafiabady, A, Hasani, J. Comparing the efficacy of emotion-focused cognitive-behavioral therapy with mindfulness based cognitive therapy on body image and cognitive fusion in adolescent girls interested in cosmetic surgery. J Cosmet Dermatol 2020;11:107–18.Suche in Google Scholar
14. Annis, NM, Cash, TF, Hrabosky, JI. Body image and psychosocial differences among stable average weight, currently overweight, and formerly overweight women: the role of stigmatizing experiences. Body Image 2004;1:155–67. https://doi.org/10.1016/j.bodyim.2003.12.001.Suche in Google Scholar PubMed
15. Zare, E, Bahrami, N, Soleimani, MA. Comparison of self-esteem in fertile and infertile women. Iran J Nurs 2014;27:14–21. https://doi.org/10.29252/ijn.27.90.91.14.Suche in Google Scholar
16. Ackerman, CE. What is self-esteem? A psychologist explains; 2021 [updated 18-01-2021]. Available from: https://positivepsychology.com/self-esteem.Suche in Google Scholar
17. Huebscher, BC. Relationship between body image and self-esteem among adolescent girls. J Soc Psychol 2010;146:15–30.Suche in Google Scholar
18. Baumeister, RF. Self-esteem: the puzzle of low self-regard. New York: Springer Science & Business Media; 2013.Suche in Google Scholar
19. Sowislo, JF, Orth, U. Does low self-esteem predict depression and anxiety? A meta-analysis of longitudinal studies. Psychol Bull 2013;139:213. https://doi.org/10.1037/a0028931.Suche in Google Scholar PubMed
20. Masselink, M, Van Roekel, E, Oldehinkel, A. Self-esteem in early adolescence as predictor of depressive symptoms in late adolescence and early adulthood: the mediating role of motivational and social factors. J Youth Adolesc 2018;47:932–46. https://doi.org/10.1007/s10964-017-0727-z.Suche in Google Scholar
21. Self-esteem: the University of Texas at Austin; 2020 [cited 2021]. Available from: https://cmhc.utexas.edu/selfesteem.html.Suche in Google Scholar
22. Kolubinski, DC, Frings, D, Nikčević, AV, Lawrence, JA, Spada, MM. A systematic review and meta-analysis of CBT interventions based on the Fennell model of low self-esteem. Psychiatr Res 2018;267:296–305. https://doi.org/10.1016/j.psychres.2018.06.025.Suche in Google Scholar
23. Jarry, JL, Ip, K. The effectiveness of stand-alone cognitive-behavioural therapy for body image: a meta-analysis. Body Image 2005;2:317–31. https://doi.org/10.1016/j.bodyim.2005.10.001.Suche in Google Scholar
24. Rosen, JC, Saltzberg, E, Srebnik, D. Cognitive behavior therapy for negative body image. Behav Ther 1989;20:393–404. https://doi.org/10.1016/s0005-7894(89)80058-9.Suche in Google Scholar
25. Raziye, S, Shamsi, S, Ghodsi, A. Determining the effectiveness of cognitive-behavioral therapy on reducing social anxiety (with emphasis on correction negative body image) female students in the first grade of high school in Karaj. In: International conference on humanities, psychology and social sciences; 2015.Suche in Google Scholar
26. Hakimi, A, Jafary Nodoushan, A, Tarazi, Z, Aghaei, H, Saberi, F. The effect of cognitive-behavioral training based on self-esteem on social adjustment and academic achievement motivation of first-grade high school female students in Ashkezar. Iran J Learn Memory 2019;1:59–65.Suche in Google Scholar
27. Bakhshi, Z, Asadi Younesi, MR, Khamesan, A. The effect of self-esteem education with cognitive-behavioral approach on academic motivation in female students. Int J Schooling 2020;2:45–54.Suche in Google Scholar
28. Valenzuela, F, Lock, J, Le Grange, D, Bohon, C. Comorbid depressive symptoms and self‐esteem improve after either cognitive‐behavioural therapy or family‐based treatment for adolescent bulimia nervosa. Eur Eat Disord Rev 2018;26:253–8. https://doi.org/10.1002/erv.2582.Suche in Google Scholar PubMed PubMed Central
29. Naghdi, Z. Comparison of puberty health group counseling effects based on cognitive-behavioral approach on self-esteem of the female high school students with and without participation of mothers; 2018. Avaiable at: https://www.irct.ir/trial/24360.Suche in Google Scholar
30. Krebs, G, de la Cruz, LF, Monzani, B, Bowyer, L, Anson, M, Cadman, J, et al.. Long-term outcomes of cognitive-behavioral therapy for adolescent body dysmorphic disorder. Behav Ther 2017;48:462–73. https://doi.org/10.1016/j.beth.2017.01.001.Suche in Google Scholar PubMed
31. Jassemi Zargani, A, Johari Fard, R. The effectiveness of cognitive-behavioral based art therapy approach on the self-concept, body image in adolescent girls with body dysmorphic disorder in Ahvaz city. Shenakht J Psychol Psychiatry 2019;6:11–22. https://doi.org/10.29252/shenakht.6.1.11.Suche in Google Scholar
32. Khoshemehry, S, Fathi, G, Javad, M. The Effectiveness of cognitive-behavioral group therapy with the emphasis on a healthy lifestyle on reducing depression, loneliness and body image in adolescent female students in Tehran. J Ministry Health Med Edu 2019;3:59–67.Suche in Google Scholar
33. Omidian, E, Rafienia, P, Rahimian Booger, E. The effect of cognitive-behavioral group therapy on disturbed body image and body dysmorphic disorder among students. J Res Health 2015;5:288–97.Suche in Google Scholar
34. Yousefian, F, Asgharipour, N. Comparative effectiveness of group mindfulness-based cognitive therapy and group cognitive-behavioral therapy on self-esteem of girl students. Psychol Psychiatry 2013;15:205–15.Suche in Google Scholar
35. Zargar, Y, Besaknezhad, S, Akhlaghi Jami, L, Zemestani, M. The comparison of the effectiveness of group training of social skills and group cognitive-behavior therapy in reducing social anxiety among students. Studies Med Sci 2014;25:172–81.Suche in Google Scholar
36. Atayi, M, Hashemi Razini, H, Hatami, M. Effect of cognitive-behavioral play therapy in the self-esteem and social anxiety of students. J Res Health 2018;8:278–85. https://doi.org/10.29252/jrh.8.3.278.Suche in Google Scholar
37. Forghani, TO, Javanbakht, M, Bayazi, MH, Sahebi, A, Vahidi, S, Derogar, K. The effectiveness of group cognitive-behavioral training and group reality therapy on self-esteem of high school students. J Fund Mental Health 2012;14:172–80.Suche in Google Scholar
38. Adriani, L, Jannah, SR, Tahlil, T. Effectiveness of group counseling improvement of body image in princess adolescents in the middle school. EAS J Nurs Midwifery 2020;2:51–8.Suche in Google Scholar
39. Prazeres, AM, Nascimento, AL, Fontenelle, LF. Cognitive-behavioral therapy for body dysmorphic disorder: a review of its efficacy. Neuropsychiatr Dis Treat 2013;9:307. https://doi.org/10.2147/NDT.S41074.Suche in Google Scholar PubMed PubMed Central
40. Mrhasani, V, Rafieepoor, A, Alavi, S. Cognitive behavioral therapy, body dismorphic disorder : a review study. Rooyesh-e-Ravanshenasi 2020;9:71–8.Suche in Google Scholar
41. Harrison, A, de la Cruz, LF, Enander, J, Radua, J, Mataix-Cols, D. Cognitive-behavioral therapy for body dysmorphic disorder: a systematic review and meta-analysis of randomized controlled trials. Clin Psychol Rev 2016;48:43–51. https://doi.org/10.1016/j.cpr.2016.05.007.Suche in Google Scholar PubMed
42. Cash, TF. The treatment of body image disturbances. Washington: J. K. Thompson; 2001.10.1037/10502-004Suche in Google Scholar
43. Taylor, TL, Montgomery, P. Can cognitive-behavioral therapy increase self-esteem among depressed adolescents? A systematic review. Child Youth Serv Rev 2007;29:823–39. https://doi.org/10.1016/j.childyouth.2007.01.010.Suche in Google Scholar
44. Hawton, KE, Salkovskis, PM, Kirk, JE, Clark, DM. Cognitive behaviour therapy for psychiatric problems: a practical guide. Oxford: Oxford University Press; 1989.10.1093/med:psych/9780192615879.003.0007Suche in Google Scholar
45. Hofmann, S, Asnaani, A, Vonk, I, Sawyer, A, Fang, A. The efficacy of cognitive behavioral therapy: a review of meta-analyses. Cognit Ther Res 2012;36:427–40. https://doi.org/10.1007/s10608-012-9476-1.Suche in Google Scholar PubMed PubMed Central
© 2021 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Reviews
- Effective strategies to improve health worker performance in delivering adolescent-friendly sexual and reproductive health services
- Sleep disturbance and depression in adolescence: an integrative review of literature
- Multiple behavioural risk factors of non-communicable diseases among adolescents in four Caribbean countries: prevalence and correlates
- The post 16 gap: how do young people conceptualise PE? An exploration of the barriers to participation in physical education, physical activity and sport in senior school pupils
- The effect of cognitive behavior therapy on body image and self-esteem in female adolescents: a systematic review and meta-analysis
- Polycystic ovary syndrome and reproductive health of women: a curious association
- Correlation between obesity, gestational diabetes mellitus, and pregnancy outcomes: an overview
- Mindfulness and eudaimonic well-being: the mediating roles of rumination and emotion dysregulation
- Acute neurological conditions during pregnancy and their management: a review
- Depression and anxiety in women with polycystic ovarian syndrome: a literature survey
- Significance of sugar intake in young adults: a review
- Original Articles
- Prevalence and factors associated with smoking among Tunisian secondary school-adolescents
- Physical fitness and its association with overweight among early adolescents in Puducherry, Southern India
- Knowledge and awareness of individual sickle cell genotype among adolescents in a unity school in Southeast, Nigeria: a cross-sectional study
- Popular water pipe smoking, medical sciences students' awareness, perceptions, and motivations
- Investigation E-health literacy and correlates factors among Alborz medical sciences students: a cross sectional study
- Risk of eating disorders in university students: an international study in Hungary, Poland and Ukraine
- Prevalence and associated factors of oral and hand hygiene behaviour among adolescents in six Southeast Asian countries
- Assessment of academic performance of licensed athletes
- Gender-based differences in risk-taking behaviors among high school students in Southeast Iran
- Experience of sexual and gender minority youth when accessing health care in Turkey
- Use of modern contraceptives among advanced-level secondary school girls in the Rukwa Region, Tanzania, 2018
- The effect of poetry reading on self-concept of primary adolescents
- The association of acne and menstrual symptoms among young women (18–25 years) in Egypt: a population-based cross-sectional study
- Sexual risk behaviors and influencing factors among Muslim adolescents on southern border of Thailand
- Not just studies, but fitness can also get you the intelligence and the grades!!
- Effectiveness of a school-based intervention in Guatemala to increase knowledge of sexual and reproductive health
- Stressful life events and depressive symptoms among adolescents in Malaysia: the mediating role of maladaptive cognitive schema
- Sexual risk behaviour and its correlates among adolescents in Indonesia, Laos, Thailand and Timor-Leste: results from national school surveys in 2015
- Utilization rate and factors influencing the use of HIV counseling and testing services among young females: a community-based study from Nigeria
- Pattern and quitting of tobacco smoking among Egyptian university students
- Association between parents and peer attachment with health locus of control: a cross-sectional study among Iranian adolescents
- Body dissatisfaction and its association with domains of physical activity and of sedentary behavior in a sample of 15,632 adolescents
- Effect of Bhramari pranayama practice on simple reaction time in healthy adolescents – a randomized control trial
- Short Communications
- Survey of school nurses’ experiences of providing counselling on sexual orientation to high school students in Japan
- Prevalence and correlates of fruit and vegetable consumption among adolescents in Laos
Artikel in diesem Heft
- Frontmatter
- Reviews
- Effective strategies to improve health worker performance in delivering adolescent-friendly sexual and reproductive health services
- Sleep disturbance and depression in adolescence: an integrative review of literature
- Multiple behavioural risk factors of non-communicable diseases among adolescents in four Caribbean countries: prevalence and correlates
- The post 16 gap: how do young people conceptualise PE? An exploration of the barriers to participation in physical education, physical activity and sport in senior school pupils
- The effect of cognitive behavior therapy on body image and self-esteem in female adolescents: a systematic review and meta-analysis
- Polycystic ovary syndrome and reproductive health of women: a curious association
- Correlation between obesity, gestational diabetes mellitus, and pregnancy outcomes: an overview
- Mindfulness and eudaimonic well-being: the mediating roles of rumination and emotion dysregulation
- Acute neurological conditions during pregnancy and their management: a review
- Depression and anxiety in women with polycystic ovarian syndrome: a literature survey
- Significance of sugar intake in young adults: a review
- Original Articles
- Prevalence and factors associated with smoking among Tunisian secondary school-adolescents
- Physical fitness and its association with overweight among early adolescents in Puducherry, Southern India
- Knowledge and awareness of individual sickle cell genotype among adolescents in a unity school in Southeast, Nigeria: a cross-sectional study
- Popular water pipe smoking, medical sciences students' awareness, perceptions, and motivations
- Investigation E-health literacy and correlates factors among Alborz medical sciences students: a cross sectional study
- Risk of eating disorders in university students: an international study in Hungary, Poland and Ukraine
- Prevalence and associated factors of oral and hand hygiene behaviour among adolescents in six Southeast Asian countries
- Assessment of academic performance of licensed athletes
- Gender-based differences in risk-taking behaviors among high school students in Southeast Iran
- Experience of sexual and gender minority youth when accessing health care in Turkey
- Use of modern contraceptives among advanced-level secondary school girls in the Rukwa Region, Tanzania, 2018
- The effect of poetry reading on self-concept of primary adolescents
- The association of acne and menstrual symptoms among young women (18–25 years) in Egypt: a population-based cross-sectional study
- Sexual risk behaviors and influencing factors among Muslim adolescents on southern border of Thailand
- Not just studies, but fitness can also get you the intelligence and the grades!!
- Effectiveness of a school-based intervention in Guatemala to increase knowledge of sexual and reproductive health
- Stressful life events and depressive symptoms among adolescents in Malaysia: the mediating role of maladaptive cognitive schema
- Sexual risk behaviour and its correlates among adolescents in Indonesia, Laos, Thailand and Timor-Leste: results from national school surveys in 2015
- Utilization rate and factors influencing the use of HIV counseling and testing services among young females: a community-based study from Nigeria
- Pattern and quitting of tobacco smoking among Egyptian university students
- Association between parents and peer attachment with health locus of control: a cross-sectional study among Iranian adolescents
- Body dissatisfaction and its association with domains of physical activity and of sedentary behavior in a sample of 15,632 adolescents
- Effect of Bhramari pranayama practice on simple reaction time in healthy adolescents – a randomized control trial
- Short Communications
- Survey of school nurses’ experiences of providing counselling on sexual orientation to high school students in Japan
- Prevalence and correlates of fruit and vegetable consumption among adolescents in Laos
